Healthcare Management & Administration Blog

Global Maternal Mortality Rates are Grim—And the U.S. is Not Excluded

May 11, 2018

This blog post is taken from the recent HealthStream article “With Maternal Mortality Rates on the Rise, OB Risk Must be a Priority.”

Rising Maternal Mortality Rates

Dying in childbirth is often assumed to be a thing of the past—we now live in an age where we have an understanding of nutrition and infection and access to clean water, modern medicine, and antibiotics. However, the statistics are still grim. Every day over 800 women die due to a complication in pregnancy or childbirth, and most of these deaths could be prevented. And while 88 percent of these deaths occur in sub-Saharan Africa and South Asia, maternal mortality is not only a problem for developing regions (UNICEF, 2018).

More than 700 American women die annually as a result of pregnancy or delivery complications (CDC Foundation, 2018). This is the highest maternal mortality rate of any high resource country, and along with Afghanistan and Sudan it is one of three countries in the world where the rate is rising instead of falling (Council on Patient Safety in Women’s Health Care, 2018).

Causes of Pregnancy-Related Deaths

The World Health Organization (WHO) reports that most complications develop during pregnancy and are preventable or treatable. With hemorrhage as the leading cause of maternal mortality globally (UNICEF, 2018), WHO cites five major complications that account for nearly 75 percent of all maternal deaths (WHO, 2018):

Severe bleeding (mostly bleeding after childbirth)

Infections (usually after childbirth)

High blood pressure during pregnancy (pre-eclampsia and eclampsia)

Complications from delivery

Unsafe abortion

In a recent CDC Foundation study conducted by US maternal mortality review committees (MMRC), experts assessed US pregnancy-related deaths from nine state-based MMRCs. The study reports, “Nearly 50% of all pregnancy-related deaths were caused by hemorrhage, cardiovascular and coronary conditions, cardiomyopathy, or infection. The leading underlying causes of death varied by race. Preeclampsia and eclampsia, and embolism were leading underlying causes of death among non-Hispanic black women” (2018).

Preventing Pregnancy-Related Deaths

The CDC Foundation study estimated that 63.2 percent of all pregnancy-related deaths were preventable. Of the top two underlying causes of these deaths, 68.2 percent of cardiovascular and coronary conditions and 70 percent of hemorrhage deaths were estimated to be preventable (2018).

The Alliance for Innovation on Maternal Health (AIM) suggests that accurate measurement of maternal mortality is an essential first step in prevention efforts. Experts with AIM point out that the US has not published an official maternal mortality rate since 2007 due to data collection discrepancies (Council on Patient Safety in Women’s Health Care, 2018). Regardless of the data problems, the dangers of US maternal mortality are imminent. Hospitals must focus on preparing their perinatal care staff for emergencies. Without adequate supplies and protocols in place to address these known risks, there is no path for improvement of death rates.

If we are going to reverse the direction of our maternal mortality rates to match the rest of the industrialized world, we must ensure that our hospitals and staff are a part of national and global initiatives to collect data, engage in research, and improve their ability to handle high-risk obstetric emergencies and thereby, save mothers’ lives.